Corporate Director of Payor Relations

Neuropsychiatric Hospitals•South Bend, IN

About The Position

The Corporate Director of Payor Relations is responsible for negotiating and managing payor contracts, optimizing reimbursement strategies, and ensuring seamless provider enrollment and credentialing. This role serves as the primary liaison between the company and payors, fostering strong relationships to drive favorable contract terms and resolve payment issues. The ideal candidate has extensive experience in payor contracting within the healthcare industry, preferably in Behavioral Health, and possesses a deep understanding of reimbursement methodologies, managed care policies, and regulatory compliance.

Requirements

Bachelor’s degree in healthcare administration, business, finance, or healthcare management related field.
Minimum of seven (7) years of experience in payor contracting and provider enrollment within a healthcare company or health plan.
Strong knowledge of managed care contracting, reimbursement methodologies, payor policies, and regulatory compliance.
Excellent negotiation, analytical, and problem-solving skills.
Ability to build and maintain effective relationships with payors and internal stakeholders.
Strong communication and leadership skills with the ability to influence and drive strategic initiatives.

Nice To Haves

Master’s degree preferred.
Experience working in Behavioral Health preferred.

Responsibilities

Develop and implement payor contracting strategies to maximize revenue and reimbursement rates.
Negotiate and manage contracts with payors, ensuring competitive rates and terms.
Establish and maintain strong relationships with payors across all markets to support ongoing contract negotiations and issue resolution.
Identify and enroll hospitals in new payor networks, including managing out-of-network situations at admission.
Oversee hospital credentialing and recredentialing with all payor organizations.
Partner with the Billing Office to address claims denials and reimbursement discrepancies.
Stay informed on industry trends, regulatory updates, and legislative changes affecting reimbursement and payor relationships.
Collaborate with hospital leadership to identify and support growth opportunities related to new and existing service lines.
Ensure compliance with state and federal policies related to healthcare reimbursement and managed care contracting.
Monitor payor policies, enrollment statistics, and market dynamics to inform strategic decision-making.